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Breathing a little easier.


Once again the ragweed ragweed, any plant of the genus Ambrosia, coarse, weedy herbs belonging to the family Asteraceae (aster family), most of which are native to America. They have inconspicuous greenish flowers and soft subdivided leaves.  season is upon us, and if you are among the 10 percent or so of Americans sensitive to ragweed pollen, we refer you to out April issue, in which we urged you to ask your physician about steroid nasal inhalers for the relief of hay fever symptoms.

Although the sneezing To verbally tell somebody about a new and interesting Web site. See viral marketing. , sniffling and itching that characterize hay fever are desperately trouble-some for many hay fever sufferers, they are not in themselves a threat to one's health. Another symptom that often accompanies them--asthma--is, however, a problem to be treated seriously. Many persons who experience asthma during the hay fever season may also have asthma at other times of the year, and because repeated asthma attacks may permanently damage the lungs and produce emphysema emphysema (ĕmfĭsē`mə), pathological or physiological enlargement or overdistention of the air sacs of the lungs. A major cause of pulmonary insufficiency in chronic cigarette smokers, emphysema is a progressive disease that commonly , it is important to treat even casual asthma attacks vigorously.

The conventional wisdom has always been that asthma is produced by the constriction constriction /con·stric·tion/ (kon-strik´shun)
1. a narrowing or compression of a part; a stricture.constric´tive

2. a diminution in range of thinking or feeling, associated with diminished spontaneity.
 of the smooth muscles in the respiratory tract and that the treatment, therefore, is to cause these muscles to relax through use of bronchodilators Bronchodilators Definition

Bronchodilators are medicines that help open the bronchial tubes (airways) of the lungs, allowing more air to flow through them.
, such as epinephrine, isooproteronol, albuterol albuterol /al·bu·ter·ol/ (al-bu´ter-ol) a ß agonist used as the base or sulfate salt as a bronchodilator.

, and the like. An overview of current asthma treatment reported in a recent issue of The New England Journal of Medicine The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world.  points to "an overreliance on bronchodilators," which are "potentially harmful and may have contributed to the recent upward trend in the rate of death from asthma."

The problems, it seems, is that it is not the smooth muscle contraction per se that causes asthma, but rather the muscle contraction as the result of inflammation of the bronchial lining. It is this underlying inflammation that demands attention. The best treatment for this inflammation is the use of inhaled steroids, the same type of drug used in the relief of nasal inflammation due to pollen allergy.

Dr. Peter Barnes, the physician who oversaw the NEIW NEIW National Ethical Investment Week  study, believes these steroids are "grossly underused" in treating asthma. Just as many doctors seem to be reluctant to prescribe the nasal steroid inhalers to treat hay fever and other pollen allergies, so are they reluctant to treat asthma because they fear these powerful drugs may have a deletrious effect on the body's hormonal balance. Nevertheless, because steroid doses sprayed directly into the nasal and bronchial passages are very low, and because very little of the medication is actually absorbed into the bloodstream, the benefits of using inhaled steroids far outweigh any potential harm they may do when properly prescribed.

Patients, too, may fear steroids. Also, some who have tried them and been disappointed with the results may not have given them an adequate trial. Steroids, because they deal with the underlying inflammation that causes the asthmatic symptoms, may take days or weeks to bring relief--but the relief is not just temporary. There are many forms of steroids and inhalers. If you suffer from asthma and your doctor has not yet prescribed one, ask about this modern form of therapy. If you doctor can't give you a good reason for not prescribing the medication, ask to be referred to an allergist al·ler·gist
A physician specializing in the diagnosis and treatment of allergies.

allergist Immunology A physician, who is often trained in both internal medicine and clinical immunology and who manages Pts with
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Title Annotation:asthma treatment with steroid nasal inhalers
Publication:Medical Update
Date:Aug 1, 1990
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